Because children and adolescents often don't tell anyone about troubling thoughts and feelings, it is up to adults to notice symptoms of possible mental illness. The U.S. Dept. of Health & Human Services' on-line publication Child and Adolescent Mental Health lists the following warnings signs:

A child or adolescent is troubled by feeling:

Sad and hopeless for no reason, and these feelings do not go away.

Very angry most of the time and crying a lot or overreacting to things.

Worthless or guilty often.

Anxious or worried often.

Unable to get over a loss or death of someone important.

Extremely fearful or having unexplained fears.

Constantly concerned about physical problems or physical appearance.

Frightened that his or her mind either is controlled or is out of control.

A child or adolescent experiences big changes, such as:

Showing declining performance in school.

Losing interest in things once enjoyed.

Experiencing unexplained changes in sleeping or eating patterns.

Avoiding friends or family and wanting to be alone all the time.

Daydreaming too much and not completing tasks.

Feeling life is too hard to handle.

Hearing voices that cannot be explained.

Experiencing suicidal thoughts.

A child or adolescent experiences:

Poor concentration and is unable to think straight or make up his or her mind.

An inability to sit still or focus attention.

Worry about being harmed, hurting others, or doing something "bad".

A need to wash, clean things, or perform certain routines hundreds of times a day, in order to avoid an unsubstantiated danger.

Racing thoughts that are almost too fast to follow.

Persistent nightmares.

A child or adolescent behaves in ways that cause problems, such as:

Using alcohol or other drugs.

Eating large amounts of food and then purging, or abusing laxatives, to avoid weight gain.

Dieting and/or exercising obsessively.

Violating the rights of others or constantly breaking the law without regard for other people.

Setting fires.

Doing things that can be life threatening.

Killing animals.

The presence of one or more of the above symptoms indicates a need for further evaluation. Pediatricians and family physicians can refer families to psychiatrists or psychologists in their area who specialize in treating children and adolescents. For other resources, see Mental Health America's factsheet How Do I Find Treatment?